Cholestyramine is a medication used to regulate blood lipids, primarily classified as an anion exchange resin. It works by binding to bile acids in the intestines, promoting the metabolism and excretion of cholesterol, and is used to treat primary hyperlipidemia and familial hypercholesterolemia.
This drug effectively lowers low-density lipoprotein cholesterol (LDL-C, known as "bad cholesterol") in the blood, usually as an adjunct to dietary control and lifestyle modifications. Its mechanism of action differs from that of statins, and it is often combined with other lipid-lowering agents to enhance efficacy.
Common brand names include:
It belongs to the classes of "Cholesterol Absorption Inhibitors" and "Anion Exchange Resins." Its action occurs within the intestines and does not directly affect hepatic metabolic pathways, thus differing from statins in its mode of action.
Mainly used for treating primary hypercholesterolemia, especially in patients with elevated LDL-C levels. It is suitable for patients who do not achieve target levels with dietary control alone or in combination with other lipid-lowering drugs.
In specific cases, it can also be used to treat pruritus caused by liver disease or for emergency management of mineral overload (such as lead poisoning).
Mild side effects include:
Severe side effects requiring immediate medical attention include:
Contraindications: Patients allergic to the drug components or with intestinal obstruction should not use. Those with severe liver dysfunction or gastrointestinal diseases should use cautiously.
Pregnancy category C; use during pregnancy or lactation should be evaluated by a healthcare provider. Regular monitoring of liver function and lipid levels is recommended during treatment to ensure safety and efficacy.
This medication may affect the absorption of other drugs, such as:
When combined with digoxin (e.g., Digoxin), it may reduce absorption efficiency, requiring dose adjustments. Always inform your healthcare provider of all medications and supplements you are taking.
Typically available in powder form, mixed with water or other liquids to form a suspension. The starting dose is usually 4-12 grams daily, divided into 2-3 doses, with specific dosing adjusted by the physician based on lipid targets.
It is recommended to take with meals or after eating, possibly with juice or milk to reduce gastrointestinal discomfort. The powder should not be swallowed directly; it must be fully dissolved before ingestion. Continuous monitoring of blood lipid levels is necessary during treatment.
If a dose is missed, take it as soon as remembered. If it is close to the next scheduled dose, skip the missed dose and resume the regular schedule. Do not double doses to make up for a missed one.
If long-term missed doses lead to poor lipid control, discuss with your healthcare provider to adjust the medication plan and avoid self-modification of doses.
Overdose may cause severe gastrointestinal discomfort, weakness, and other symptoms. If overdose is suspected, seek immediate medical attention and bring the medication packaging for reference.
Medical interventions may include gastric lavage or administration of activated charcoal to adsorb unabsorbed drug components. Severe cases may require hospitalization for liver and kidney function monitoring.
Q: How can I avoid drug interactions when taking Cholestyramine?
A: Cholestyramine can adsorb other oral medications, reducing their absorption. It is recommended to space the intake of this drug and other medications by at least 4 to 6 hours, and adjust the sequence of administration as advised by your healthcare provider. Special attention is needed when using thyroid hormones or warfarin, with monitoring of blood concentrations.
Q: What should I do if I experience bloating or constipation while taking Cholestyramine?
A: This medication may increase water absorption in the intestines, leading to constipation. Increasing dietary fiber intake (such as whole grains and vegetables) and drinking more than 2000 ml of water daily can help. If symptoms persist, your doctor may adjust the dose or prescribe laxatives. Seek medical attention if symptoms worsen.
Q: Does Cholestyramine affect the absorption of oral contraceptives?
A: Yes, Cholestyramine may reduce the absorption of oral contraceptives. If used concurrently, take the two at least 4 hours apart and consult your healthcare provider about additional contraceptive measures. Using other methods like condoms is recommended to ensure effectiveness.
Q: What dietary precautions should I take while on Cholestyramine?
A: Avoid taking mineral supplements (such as iron or calcium tablets) or plant sterol products simultaneously; it is advisable to separate them by at least 2 hours. You can consume high-fiber foods normally but should drink adequate water in divided doses to reduce gastrointestinal discomfort. If you are using fish oil or vitamin supplements, inform your doctor to adjust the timing of medication.
Q: Is regular liver function testing necessary during long-term use of Cholestyramine?
A: Although this medication mainly affects intestinal absorption, it is recommended to check liver function every 6 to 12 months during long-term use. If jaundice, dark urine, or right upper quadrant pain occurs, stop the medication immediately and seek medical attention. Your healthcare provider will adjust the treatment plan based on lipid control and liver function results.
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